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Flashcards in Renal Deck (31):
1

what endocrine work do the kidneys do?

produce erythropoietin
activates vitamin D
controls blood pressure via RAAS

2

what are some renal investigations that can be done by looking at the urine?

dipsticks - glucose/blood/protein/WBC's
microscopy
microbiology

3

what are some renal investigations that can be done by looking at the blood?

electrolytes
glomerular filtrate rate
specific tests

4

what imaging tests can be done for renal?

plain xrays
intravenous urogram
ultrasound
MRI
CT

5

what investigations can be done via looking at the tissue?

renal biopsy

6

what are some consequences of renal failure?

oedema
high potassium - cardiac arrest
accumulation of waste products - ureamia
drug metabolism
acidosis
lack of erythropoietin
lack of vit d
high bp

7

what are some causes of renal failure?

diabetes
high bp
artherosclerosis
autoimmune - glomerulonephritis
cancer - myeloma
hypovolaemia

8

what drugs can cause renal failure by exacerbating pre existing disease?

NSAIDS
ACE inhibitors
diuretics
tetracyclines
idiosyncratic reactions - penicillin/NSAIDS

9

what infections can cause renal failure

recurrent ascending UTI's

10

what kind of obstructions can cause renal failure?

prostate
stones
abdominal/pelvic stones
polycystic kidney disease

11

what are the 2 forms of renal disease?

acute
chronic

12

what is acute renal failure?

-acute loss of renal function - normal/low absent urine -output
-life threatning - hyperkaleamia/uraemia, fluid retention, hypertension

13

is acute renal failure reversible?

often, yes

14

does acute failure happen in healthy kidneys?

usually pre existing disease

15

how to manage acute failure?

manage underlying cause
treat effects - potassium/fluid removal or replacement
dialysis?

16

what is chronic renal failure?

gradual progression of renal impairment
end stage renal disease where GFR is 5% of norm
progression depends on underlying cause and modifying factors

17

what are the most common causes of chronic renal failure?

diabetic retinopathy
glomerulonephritis
chronic renal infection
polscytic renal disease
atherosclerosis
high bp

18

what are the effects of chronic renal disease?

uraemia - reduced immunity/platelet function/malaise/nausea/itch
fluid retention - hypertension/odeama
lack of erythropoietin - anaemmia
renal osteodystrophy - secondary hyperparathyroidism

19

how to treat chronic renal failure?

avoid further damage - control hypertension/diabetes, immunosuppresion, avoid/reduce drugs, treat any obstructions
- correct anaemia - erythropoietin injections
-correct vit d deficiency

20

types of dialysis?

haemodyalasis
peritoneal dialysis

21

what are some problems that may rise from transplant?

rejection - acute/chronic
immunosuppresion - increased infection/malignancy risk
high cardiovascular mortality

22

what is a UTI?

cystitis
increased risk if impaired bladder emptying or low urinary flow rates
e.coli gram negative bacilli

23

symptoms of UTI and management?

dysurua
pain
antibiotics/increased fluid intake

24

what may cause a urinary tract obstruction?

prostate
renal calculi
external compression - abdonminal/pelvic malignancies

25

what oral problems may renal osteodyrstrophy cause?

loss of lamina dura
radiolucencies
problems with bone healing post extraction

26

why may renal patients have greater bleeding tendencies?

abnormal platelet production, diminished factor 3 and von wilebrands factor

27

when should you treat a dialysis patient in the dentist and why?

day after dialysis once heparin worn off

28

what patients may require pep before an invasive procedure?

polycystic kidneys
peritoneal dialysis
some on haemodialysis
renal transplant
discuss with renal team

29

what orofacial manifestations may be seen in renal patients?

osseus lesions - loss of LD, osteoporosis, osteolytic areas, secondary hyperparathyroidism = giant cell lesion, abnormal bone repair

30

what oral signs may a chronic renal failure patient experience?

dry mouth, halitosis, metallic taste
insidious oral bleeding/purpura, salivary gland swelling
calculus accumulations, oral ulceration and changes b/c anaemia

31

chronic renal failure in children may cause what orally?

jaw growth retarded
tooth eruption delayed
malocclusion
brownish tooth discolouration
prev tetracycline staining
low caries rate/less perio disease